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Natural Products > 11 - NHPs for MSK conditions > Flashcards

11 - NHPs for MSK conditions Flashcards

1
Q

Which NHPs are used to reduce symptoms of RA?

A
  • omega 3 fatty acids

- gamma linolenic acid

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2
Q

Which NHPs are used to reduce symptoms of OA?

A

glucosamine, chondroitin, turmeric, MSM, SAMe

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3
Q

What is rheumatoid arthritis ?

A
  • Autoimmune disorder
  • Immune system attacks joints and they are eventually weakened
  • Fingers and wrists
  • Usually symmetrical
  • Pain and inflammation
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4
Q

What is osteoarthritis ?

A
  • Wear and tear
  • Overuse of joints/age
  • Hands, knees, hips, and spine
  • Not usually symmetrical
  • Pain and inflammation in severe cases
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5
Q

What NHPs are possibly effective for RA?

A
  • borage
  • cats claw
  • fish oil
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6
Q

What NHPs have insufficient evidence for RA?

A
  • bromelain
  • collagen type 2
  • evening primrose oil
  • krill oil
  • new zealand green lipped mussel
  • turmeric
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7
Q

Do we use Thunder God Vine?

A

No - serious side effects

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8
Q

What is Fish oil also known as?

A
  • omega 3
  • PUFA (poly unsaturated fatty acids)
  • EPA
  • DHA
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9
Q

Is fish oil effective for RA?

A

may be effective as add on therapy to DMARD

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10
Q

What is gamma linolenic acid found in?

A
  • borage oil
  • black currant
  • evening primrose oil
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11
Q

Main interaction with GLA’s

A

warfarin

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12
Q

Is GLA effective in RA?

A

(evening primrose oil, borage, black current)

-probably may improve pain, may improve function

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13
Q

What are the most common NHPs used for OA?

A
  • glucosamine
  • chondroitin
  • vitamin supplements
  • shark cartilage
  • apple cider vinegar
  • garlic
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14
Q

MOA of glucosamine for OA?

A

is a precursor to glycosaminoglycans and proteoglycans that make up articular cartilage

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15
Q

Is glucosamine effective for OA?

A

insufficient reliable evidence to rate

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16
Q

What is the primary outcome of glucosamine?

A

decrease worsening of cartilage damage

17
Q

What is the secondary outcome of glucosamine?

A

change in bone marrow lesions (BML), decrease in self reported pain

18
Q

Do we recommend glucosamine?

A

No - no evidence man

19
Q

What are some contraindications to glucosamine?

A
  • shellfish allergy
  • diabetes
  • avoid in pregnancy
  • asthma - several case reports
  • not studied in renal or hepatic impairments !!
20
Q

SE of glucosamine

A

GI upset

21
Q

Drug interactions with glucosamine

A

warfarin

22
Q

MOA of chondroitin for OA

A

may prevent cartilage metabolism

23
Q

Drug interactions with chondroitin

A

theoretically may prolong bleeding times due to structural similarity to heparin

24
Q

What were the results of GAIT (glucosamien/chondroitin arthritis intervention trial) ?

A
  • reduced knee pain compared to placebo

- rate of response was better for moderate-severe pain group

25
Q

Does collagen apply to RA or OA?

A

RA

26
Q

Evidence of collagen ?

A

insufficient evidence

27
Q

Evidence for hyaluronic acid?

A

insufficient evidence but is for when given by intra-articular injections

28
Q

Is turmeric effective?

A

possibly

29
Q

MOA of turmeric?

A

may reduce inflammation by inhibiting COX-2 PGs, leukotrienes, and other cytokines involved in pro inflammatory signalling pathways

30
Q

Why is turmeric a caution with diabetes?

A

curcumin, can reduce levels of blood glucose and glycosylated hemoglobin in diabetics

31
Q

What is celedrin and is it effective?

A
  • possibly effective
  • may inhibit COX and 5-LO
  • may be a joint lubricant
32
Q

Is MSM effective?

A

-possibly effective

33
Q

Possible MOA of MSM

A
  • inhibit degenerative changes in joints

- scavenge hydroxyl free radicals which trigger inflammation

34
Q

What does SAMe do?

A

help alleviate osteoarthritis pain

35
Q

SAMe effective in OA?

A

likely

36
Q

Describe eggshell membrane

A
  • promoted for relieving joint pain in as little as 7-10 days
  • is a natural source of collage, glucosamine, chondroitin and hyaluronic acid

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